Keeping the dream alive for children with Asperger's Syndrome

Glossary

Introduction
When you read or hear about a condition such as Asperger’s Syndrome, it is common to come across technical and medical words that have little meaning to most people. Sometimes a common word is used in association with Asperger’s yet its relevance might not be known. A little while ago the Foundation commissioned a psychologist to do some research and as part of that process they produces a glossary of terms related to Asperger’s Syndrome. So if you are ever muddled or confused about a phrase someone has used, have a look in this glossary and hopefully we can help to straighten things out.NOTE: Like all information on this website the following is copyright to the Cloud 9 Children’s Foundation and is not to be reproduced without permission.

Glossary of Terms and Information About Asperger’s Syndrome

AFFECT Fluctuations of mood are frequently observed in children and adults with Asperger’s syndrome. Changes in mood can be observed in several variations: giggling or weeping for no apparent reason, absence of emotional responses or reactions to danger, excessive fearfulness or generalized anxiety.

AGITATION See Psychomotor Agitation.

ANXIETY As with Obsessive-Compulsive Disorder and panic attacks, anxiety and anxiety attacks have been argued to be a natural outgrowth from the ritualistic, perfectionist characteristics of Asperger’s.

ASPERGER’S SYNDROME A condition at the more able end of the Autistic spectrum. Essential features of Asperger’s are severe and sustained impairment in social interaction and the development of restricted, repetitive patterns of behaviour, interests, and activities. There are no clinically significant delays in language, cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than in social interaction), and curiosity about the environment in childhood. Unlike people with ‘classic autism’ who often appear withdrawn and uninterested in the world around them, many people with Asperger’s syndrome try hard to be sociable and do not dislike human contact.

ATYPICAL AUTISM Presentations that do not meet the criteria for Autism because of the late age of onset, unusual symptoms, or symptoms that do not meet the diagnostic criteria (see below) for diagnosis.

AUDITORY INTEGRATION TRAINING (AIT) was developed in response to the theory that the sound sensitivity and consequent behavioural disturbance in autism could result from hearing disturbances. AIT involves the child/adult wearing earphones attached to a machine with a variety of auditory filters that allow the sound emitting from the machine to be modified for individuals. The machine filters and amplifies specially selected music as necessary and sends the music to each ear independently. Although not widely available, some research suggest that structure listening and AIT appears to help in reducing sound sensitivity in many, but not all, children who are sound sensitive. AIT is also called the “Tomatis Method” and “Auditory Stimulation”.

AUTISTIC SPECTRUM DISORDER A complex developmental disability that affects the way a person communicates and relates to people around them. The term autistic spectrum is often used because the condition varies from person to person; some people with the condition may also have accompanying learning disabilities, while others are much more able with average or above average intelligence. Despite the wide-ranging differences, everyone with a disorder on the spectrum has difficulty with interaction, social interaction and imagination.

AUTISM The essential feature of Autism or Autistic Disorder is the presence of markedly abnormal or impaired development in social interaction, social communication and imagination, together with a very restricted range of activity and interests.

BACKWARD CHAINING Many daily living skills involve children learning a sequence of actions, which are often broken down in small steps to help the child learn. Backward chaining is a process where the child is helped to complete the last step of a sequence only, at first. For example, in teaching a child how to put on a T-shirt, the T-shirt is put on, but the child is left to pull it down (initially with the physical prompt of an adult’s hand over theirs). Once the child can do this step unaided, they are gradually taught more steps until finally no help is needed.

BROAD AUTISM PHENOTYPE Characteristics that are qualitatively similar, but milder than those that define autism – social and communication deficits and stereotyped, repetitive behaviours are present, but have less detrimental impact. These characteristics show familial aggregation in families with a member or members with Autism.

CAUSES OF AUTISTIC SPECTRUM DISORDERS The exact causes of Autistic spectrum disorders are still not known, but research shows that genetic factors are important. Autism is not the result of emotional deprivation or emotional stress, or parenting style. In some cases, Autistic spectrum disorders may be associated with conditions affecting brain development, such as maternal rubella, tuberous sclerosis, epilepsy and encephalitis.

CHILDHOOD DISINTEGRATIVE DISORDER Also on the Autistic spectrum, this disorder is a marked regression in multiple areas of functioning following a period of at least two years of apparently normal development.

CLUMSINESS Clumsy body language is sometimes seen in Autism and Asperger’s, but motor clumsiness is not a necessary part of the picture in all cases of Autism.

COMMUNICATIONVerbal : See Language Non-Verbal: Non-verbal communication problems you may see in Autism include: poor eye contact, posture, limited or inappropriate facial expression, clumsy body language, difficulty adjusting physical proximity and limited use of gestures. Nonverbal aspects of communication can be significantly different in Asperger’s syndrome. Non-verbal communication may be exaggerated, completely absent, or may appear to contradict verbal content. Children and adults also find it hard to understand non-verbal signals from others, including facial expressions.

CONCRETENESS See mental rigidity.

DAILY LIFE THERAPY (HIGASHI) Daily Life Therapy is a programme that aims to provide autistic children with a systematic education through group dynamics, modelling and physical activity. There are Higashi Schools in the UK and the USA.

DEPRESSION In adolescence or early adulthood, individuals with Autism who have the intellectual capacity for insight may become isolated and depressed in response to the realisation of their serious impairment. Symptoms or signs may include significant changes in appetite (decreased or increased appetite), behaviour or sleeping patterns. People with Asperger’s often want to be sociable and are upset by the fact that they find it difficult to make friends.

DESENSITISATION Some sensory integration therapists believe that it may be possible to reduce tactile defensiveness be gradually exposing the child with an Autistic disorder to touch in a way which is safe and enjoyable to them.

DIAGNOSTIC CRITERIA Diagnostic criteria are often used to help with diagnosing an individual within the Autistic spectrum and other conditions. All people with an Autistic spectrum condition have difficulties with social interaction, social communication and imagination. This is sometimes referred to as the triad of impairments, each of which must be present to meet the criteria for diagnosis: 1. Social interaction (difficulty with social relationships, e.g., appearing aloof and indifferent to other people). 2. Social communication (difficulty with verbal and non-verbal communication, e.g., not really understanding the meaning of gestures, facial expressions or tone of voice). 3. Imagination (difficulty in the development of play and imagination, e.g., having a limited range of imaginative activities, possibly copied and used repetitively). In addition to this triad, other diagnostic criteria include repetitive behaviour patterns and a resistance to change in routine.

DIAGNOSTIC INSTRUMENTS Several instruments exist which were designed to assist with detecting autism, with variable reliability and validity. The most popularly used and reliable of these is the Childhood Autism Rating Scale (Schopler, Reichler & Renner, 1988) which is a 15-item structured interview and observation instrument for use with children over 24 months of age. It indicates the degree to which a child’s behaviour deviates from the age-appropriate norm, and it distinguished the degree of autism. The Parent Interview for Autism (Stone & Hogan, 1993) is designed to obtain diagnostically relevant information from parents of young children suspected of having autism. Other examples are the Autism Behaviour Checklist and the Behavioural Rating Instrument for Autistic and Other Atypical Children.

DIETARY INTERVENTIONS Supporters of this type of intervention argue that certain foods or combinations of foods can have an aversive or beneficial effect on Autism. It now seems that some people with Autism may suffer a metabolic disorder causing them to be unable to completely digest certain foods. For some children, a special diet, such as eating no grain, wheat or diary products can help. Such children may be helped by going on what is known as a gluten (grain or wheat) and/or casein (diary) free diet. For others, taking vitamins, such as Vitamin B6 and magnesium is beneficial.

DRUGS There is no drug that can cure Autism. However, some drugs can be used to help associated problems such as sleeping difficulties, hyperactive behavior etc.

DYSPRAXIA Sometimes also called Developmental Co-ordination Disorder, Dyspraxia is often referred to as a disorder of gesture. Features of dyspraxia consist primarily of abnormal motor behavior such as difficulties with balance and co-ordination, limited gestural motor tasks, clumsiness, and difficulty with fine motor tasks. Developmental Verbal Dyspraxia refers to an intelligible or atypical speech production. Children and adults with an Autistic Spectrum Disorder often show several signs of both verbal and motor dyspraxia. Dyspraxia in children is often compared to and contrasted with adult acquired apraxia.

ECHOLIA A parrot-like repetition of a word or phrase just spoken by another person. This echoing is apparently senseless and without meaning.

EDUCATION This is thought to be one of the best ways of helping children with Autism and there are a number of methods of teaching that can help. Some children attend special schools where teachers are specially trained in teaching children with Autism, whereas other children attend mainstream schools.

EGOCENTRICITY Egocentrism is a bias toward interpreting events from your own (ego’s) point of view without taking into consideration alternative (other people’s) perspectives. Between the ages of about 5 and 12 years a child’s tendency to be egocentric usually declines which can increase the effectiveness of communication as children are able to consider the views of others, anticipate how others will behave and develop skills at negotiating social interactions with peers. Children with Autism however, often do not experience the normal developmental decline in egocentricity, which in turn limits the above communicative and imaginative abilities.

EMPATHY Empathy is the ability to understand how only people are feeling and to identify with the likely emotions. Developing empathy involves several processes: recognizing the emotional state of another person; perspective taking; having a similar emotional response; and acting on it (e.g., expressing sympathy). People with Asperger’s often have difficulty expressing or feeling empathy because of not being able to complete one or more of these processes involved in developing empathy.

FACILITATED COMMUNICATION At times controversial, FC is used as an alternative means of communication for people with no, or extremely dysfunctional speech. The FC facilitator normally supports a client’s hand, wrist or arm while that person uses a communicator to spell out words, phrases or sentences. Use of FC with people with autism is centred on the notion that many of the difficulties faced are due to a movement disorder, rather than social or communication deficits.

GENETICS Although the exact causes of Autistic spectrum disorders are still not known, research shows that genetic factors are important. Twin and family studies clearly support genetic factors as important in Autism, but linkage analysis studies indicate that many genes may be involved.

GRAPHOMOTOR DEVELOPMENT Those fine motor skills associated with handwriting and drawing.

HOLDING THERAPY An approach to behavior management which involves forcibly holding and hugging the autistic child until they stop resisting. Holding Therapy was primarily used in the 1980’s, but has since declined in popularity because of the large amount of evidence that it is extremely distressing, aversive and stressful for the child. It is now believed by a majority of people with, and working with an Autistic disorder, that the most effective management approach is a non-aversive one that does not use punishment or physical restraint, and reduces stress and anxiety.

HYPERACUSIS Excessive auditory sensitivity.

HYPERLEXIA A precocious ability to rote – read at an early age. Can be a common feature of the learning profile in Asperger’s syndrome.

IMAGINATION While they often excel at learning facts and figures, people with Asperger’s find it hard to think in abstract ways. This can cause problems for children in school where they may have difficulty with certain subjects such as English or creative writing.

KANNER SYNDROME Also on the Autistic spectrum. Sometimes referred to as ‘classic autism’.

LANGUAGE Expressive Language People with Asperger’s tend to have average or above average intelligence and so generally have fewer problems with language than classic autism. People with autism often speak fluently, although their words can sometimes sound formal or stilted. Vocal characteristics can be very different in children with Asperger’s syndrome, whose voices may sound rather flat, due to monotone, robotic phrasing and inflection patterns.
Figurative Language Despite having good language skills, people with Asperger’s syndrome may sound over precise or over-literal. Jokes can cause problems as can exaggerated language and metaphors, e.g., a person with Asperger’s may be confused or frightened by a statement like “she bit my head off”. Receptive Language Although people with Asperger’s may speak very fluently, but they may not take much notice of the reaction of people listening to them; e.g., they may talk on and on regardless of the listener’s interest and may appear insensitive to other people’s feelings. Typically language is understood and used very literally, and while they often excel at learning facts and figures, Asperger’s children and adults find it hard to think in abstract ways. Pragmatic Language Pragmatic or conversational language skills are often weak because of problems with turn-taking, unsociable comments, interrupting, a tendency to revert to areas of special interest, or difficulty sustaining the “give-and-take” of conversations. Communication is sometimes described as “talking at” others, e.g., monologue on a favorite subject that continues despite attempts at others to interject comments.

LOVAAS The LOVAAS method is an early intensive behaviour therapy approach for children with autism and other related disorders. It is both a clinic based and home-supported based programme, with (now) an emphasis on positively reinforcing learnt skills with food, a toy, and gradually moving through to more social and everyday reinforcers such as hugs and tickles. All skills are broken down into small tasks that are achievable and taught in a very structured manner, accompanied by lots of praise and reinforcement.

MANUAL DEXTERITY This area of movement skills involves the ability to use both hands, for example – learning to dress, eat with utensils, tie shoelaces. This may also extend to the co-ordination of feet and legs as in learning to ride a bicycle. Manual dexterity can be difficult, limited or absent in Autism.

MENTAL RETARDATION The relation between autism and intellectually handicap has been a source of confusion for a long time. Many have noted that the intellectual impairments in people with Autism resemble the limitations of intellectually handicapped people. Compared with intellectually handicapped people however, individuals with Autism have more intellectual strengths – which can be above average in some areas – and a wider spread between their skills and deficits. Gross motor skills of autistic children also tend to be stronger. Intellectually handicapped children however, generally have better social and communication skills in relation to their overall developmental levels. The relationship between autism and intellectual handicap has been clarified more recently with the acknowledgement that autism can and does co-exist with other disabilities – the most common of which is “mental retardation” (current estimates of co-morbidity are 70%).

MENTAL RIGIDITY Thinking patterns can be very rigid in Autism. Concepts are viewed as black or white, with subtle variations very difficult to understand. For example, a specific number can be “few” in some situations, but “many” in another situation, it is all relative. This way of interpreting information is extremely challenging to individuals with Asperger’s syndrome. The egocentric features of Asperger’s also contribute to mental rigidity, as situations tend to be seen from their perspective only.

MIND BLINDNESS An inability to pick up social cues and nuances (e.g., facial expressions).

MONOTROPIC INTEREST SYSTEMS People with “monotropic interest systems”, including individuals with autism, have their attention fixed on isolated objects which are viewed as though through a tunnel, separate from the surrounding context.

MOTOR SKILLS / MOVEMENT Motor skills can be divided into two broad categories. Fine motor skills consists of activities such as writing with a pen/pencil, doing up buttons and eating with utensils. Gross motor skills involve the coordination and development of larger activities such as kicking a ball, running, swimming and jumping. To varying degrees both fine and gross motor skill development can be impaired in children with Autism.

MUSIC THERAPY Supporters of music therapy argue that music can stimulate and develop more meaningful and playful communication in people with Autism. Music therapy is led by a trained musician, and most rely on spontaneous musical improvisation, where the therapist uses percussion or tuned instruments, or their own voice, to respond creatively to the sounds produced by the child/adult, and encourage the child to create his or her own musical language.

MUSICAL INTERACTION THERAPY (MIT) has been used with Autistic children at certain schools to reinforce speech-language therapy, rather than used on its own. MIT differs from music therapy in that the musical interaction therapy practitioner is not required to be a musician.

OBSESSIVE-COMPULSIVE DISORDER (OCD) Has been argued to sometimes be a natural outgrowth from the ritualistic, perfectionist characteristics of Asperger’s for some individuals.

OPTIONS SON-RISE PROGRAMMEME This programme uses an interactive approach to early intervention – emphasizing the importance of developing a relationship and communication between the child and parents. The programme is child-centered: the child is not judged and their behaviors are not seen as good or bad, rather the child is seen to be doing the best he/she can. The Son-Rise philosophy encourages the parent (or therapist, instructor of facilitator) to “become the student of the child’s world, observing, learning, assisting and supporting the child’s development in a loving and non-judgmental environment”. Parents are trained and then set up and manage the programme in their own home. Options Son-Rise programmes are especially popular in the UK and USA>

PANIC ATTACKS As with Obsessive-Compulsive Disorder and anxiety attacks, panic attacks have been argued to be a natural outgrowth from the ritualistic, perfectionist characteristics of Asperger’s.

PERSEVERATION The tendency to repeat a certain phrase or activity despite other’s attempts to interrupt, other’s disinterest or fatigue. Perseveration can be seen in Autistic people – particularly in the routines and ritualistic behaviour that often characterizes the Autistic Spectrum Disorders.

PERVASIVE DEVELOPMENTAL DISORDERS (PDD) Disorders characterized by severe and pervasive impairment in several areas of development: reciprocal social interaction skills, communication skills, communication skills, or the presence of stereotyped behaviour, interests and activities. Autism and Asperger’s both fall under the category of PDD as does Rett’s disorder, Childhood Disintegrative Disorder and PDD – not otherwise specified (NOS).

PERVASIVE DEVELOPMENTAL DISORDER NOT OTHERWISE SPECIFIED A diagnosis of PDD-NOS (also called atypical Autism) may be made when a child does not meet the criteria for a specific diagnosis, but there is a severe and pervasive impairment in specified behaviors.

PHYSIOTHERAPY Can be helpful to suggest strategies to improve gross-motor coordination.

PICTURE SYMBOLS Not all children with Autism learn to speak, or they can only speak one or two words. It is therefore important to teach alternative forms of communication. One method that is increasingly being used is the Picture Exchange Communication System or PECS for short. This involves the child showing or pointing to a card with a picture. For example, if the child is thirsty, they can point to a picture of a cup. Gradually, the child learns to build up a sentence from cards, e.g., I want a drink. Alongside this, some children also learn to ask for what they want verbally.

PRAGMATIC DEFICITS See Language: Pragmatic Language.

PREVALENCE The prevalence of Autism is approximately 1 per 2000 people, the prevalence of Autism and Asperger’s together is 1 per 1000 people. Although it is not known why, boys are affected more than girls. For Autism the sex ratio is four males to one female, for Asperger’s syndrome, the ratio is nine males to one female.

PROCESSING The ability to accurately attach meaning to stimuli. Can be impaired in some Autistic children and adults.

PROSODY Often a flat or unusual tone, that can present as a ‘foreign accent’. Prosody means that there is a lack of vocal inflection, and a lack of varying pitch and volume levels, rate, rhythm and inflection.

PROTO-DECLARATIVE POINTING This type of pointing is to declare an interest in something as opposed to proto-imperative pointing which is used for requesting something. Proto-declarative pointing is deficient in children with an autistic spectrum disorder.

PSYCHOLOGY Psychologists can be helpful in both assessment and therapy of the autistic spectrum disorders. A psychologist may need to monitor emotional stability and provide counselling and education (information) services as needed if the child or adult becomes overwhelmed or frustrated.

PSYCHOMOTOR AGITATION Excessive motor activity associated with a feeling of inner tension. The activity is usually non-productive, repetitious and consists of behaviour such as pacing, fidgeting, wringing hands, pulling of clothes and an inability to sit still.

PSYCHOMOTOR RETARDATION A visible generalised slowing of movements and speech.

REPETITIVE ACTIVITY / BEHAVIOUR Restricted, repetitive and stereotyped patterns of behavior, interests and activities are one of the defining features of Asperger’s. These can be shown by at least one of the following: · An encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus. · Apparently inflexible adherence to specific, non-functional routines or rituals. · Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements). · Persistent preoccupation with parts of objects.

RETT’S SYNDROME Also on the Autistic spectrum, Rett’s syndrome is the development of multiple, specific deficits (e.g., loss of purposeful hand movements replaced with repetitive hand movements) following a period of normal functioning after birth, usually beginning between the ages of 1 and 4 years. To date, only occurs in girls.

RITUALS People with Asperger’s often prefer to order their day according to a set pattern. Any enforced or perceived disruptions to their self-imposed rituals can cause anxiety or distress.

ROUTINES For people with Asperger’s syndrome, any unexpected change in routine can be upsetting. Examples of routines used by Asperger’s children include: an insistence on following an identical route to school each day; a lengthy bed-time ritual; or the repetition of a sequence of odd bodily movements. Also see Repetitive Activity / Behavior.

SELF INJURIOUS BEHAVIOUR Self-injurious behavior such as head banging and finger or hand biting are among the most extreme and frightening of the behaviors accompanying Autism. These occur in less than 10% of the Autistic population, but can be the most difficult to control or suggest a remedy for.

SEMANTIC PRAGMATIC DISORDER Semantic Pragmatic Disorder was originally used to describe a developmental language disorder, affecting two aspects of communication: “semantics” and “pragmatics”. It belongs within the autistic spectrum and has the same underlying triad of socio-cognitive deficits as high functioning autism or Asperger’s. Partly because of the argument that “semantic pragmatic disorder” is not an appropriate diagnosis, but merely a descriptive term for the nature of communication difficulty found in verbal people with autism, the term is no longer used.

SENSORY SENSITIVITIES Under- and over-responsitivity to sensory input are common in Autism; some children resist being touched while others ignore sensitivities like pain. Specific sounds or tastes fascinate many Autistic people.

SLEEP PROBLEMS Problems with sleeping behavior are frequently observed in individuals with Asperger’s. Sleep problems often resolve themselves by adolescence, but can be difficult prior to then. Staying up all night is among the most difficult of the ongoing problems that parents face with young Autistic children.

SOCIAL COMMUNICATION / INTERACTION Social characteristics you may see in a child with Autism include: · Communication concerns - doesn’t respond to his/her name - doesn’t point or wave goodbye - appears deaf at times - used to say a few words, now doesn’t - doesn’t follow directions - No babbling by 12 months - No gesturing by 12 months - No single words by 16 months · Social concerns - doesn’t smile socially - seems to prefer playing alone - has poor eye contact - is not interested in other children - tunes people out - is very independent - is in his/her own world - does things ‘early’ · Behavioral concerns - tantrums - hyperactive/oppositional/uncooperative - has unusual attachments to toys - is oversensitive to certain textures or sounds - has odd movement patterns

SPECIAL INTERESTS People with Asperger’s often develop an almost obsessive interest in a hobby or collection. Usually their interest involves arranging or memorizing facts about a specialist subject.

SPECTRUM DISORDERS Autism is a spectrum disorder which means that the symptoms and characteristics of Autism can present themselves in a wide variety of combinations from relatively mild to severe. Although Autism is defined by a certain set of behaviors, children and adults can exhibit any combination of the behaviors in any degree of severity.

SPEECH LANGUAGE THERAPY (SLT) can be very useful for Autistic children with a speech impediment, limited or no speech skills.

SPELL SPELL is an acronym for Structure, Positive, Empathy, Low Arousal, and Links. It is the method of intervention used by the National Autistic Society (NAS) in the United Kingdom. NAS say the SPELL approach has been refined to recognize the individuality of each child or adult with an Autistic spectrum disorder including Asperger’s. It is a holistic approach that sees every child/adult as a unique individual while acknowledging that they share similar experiences and difficulties. They say SPELL describes the necessary environment and support environment that enables the child to learn while minimizing stress. NAS’s description of the SPELL approach is as follows: · Structure: helps the child to make sense of a very confusing world. · Positive: attitudes and appropriately pitched expectations enhance the child’s self esteem and self-confidence. · Empathy: Empathy is crucial to see the world from the child’s unique viewpoint and to understand their perceptions. · Low Arousal: The child’s learning environment needs to be clear, calm and clutter free. · Links: With parents and mainstream education.

SQUEEZE MACHINE Invented by Temple Grandin who has autism, this is essentially as the name suggests. An individual puts themselves into the machine and is ‘squeezed’ to various degrees. The squeeze machine therefore allows a person with an autistic spectrum condition to explore touch and deep pressure in a way that is completely under their control.

TACTILE DEFENSIVENESS / HYPERSENSITIVITY The nervous system appears to overreact to touch, so that a ‘friendly’ touch is perceived as overwhelming and invasive. This is not true for everyone with an autistic spectrum condition, as some enjoy certain forms of active physical contact.

TEACCH Treatment and Education of Autistic and Related Communication Handicapped Children. TEACCH provides a wide range of services to children, adults and families, has a research programmeme and provides multidisciplinary training for professionals working with autism. Their stated aim is to help to prepare people with autism to live or work more effectively at home, at school and in the community.

THEORY OF MIND (ToM) Theory of Mind refers to the capacity to attribute mental states to oneself and others in an attempt to understand and explain, and to predict other’s behavior. ToM is not fully developed in children or adults with Autism.

TOMATIS METHOD See Auditory Integration Training.

TREATMENT An autistic spectrum disorder is a life-long disability and there is at present no one effective treatment that appears to work for everyone. However, given appropriate intervention early in life, specialized education and structured support can make a difference to a child’s life, helping to maximize their skills and achieve their full potential as adults. Although there is no documented “cure” for Autism, research suggests that it can be managed effectively using comprehensive behavioral and educational treatment programmes. Social pragmatic approaches, augmented by individualized strategies and social coaching, may be best for teaching social communication skills. Pharmacological interventions have a limited role in improving asocial communication, but may help ameliorate depression, hyperactivity and other secondary problems. For a definition and brief description of the various treatment approaches, refer to the appropriate place in this glossary.

TRIAD OF IMPAIRMENTS Autistic spectrum disorders are characterized by impairments in social interaction, social communication and imagination which can occur in varying degrees of severity. This triad is generally accompanied by a limited, narrow, repetitive pattern if activities. Also see Diagnostic Criteria